Nursing Elites

1. A patient is admitted to the emergency room and is found to have proteinuria, a low serum albumin level, edema, and elevated blood lipids. Which condition do these symptoms typically associate with?

• A. Nephrotic syndrome
• B. Acute kidney injury
• C. Rejection of a kidney transplant
• D. Renal colic

Correct answer: A

Rationale: The correct answer is A: Nephrotic syndrome. Nephrotic syndrome is characterized by proteinuria (excess protein in urine), hypoalbuminemia (low serum albumin), edema (swelling due to fluid buildup), and hyperlipidemia (elevated blood lipids). These symptoms occur as a result of damage to the kidneys' filtering units. Acute kidney injury, rejection of a kidney transplant, and renal colic do not present with the same combination of symptoms as nephrotic syndrome. Acute kidney injury typically presents with a sudden decrease in kidney function, resulting in a build-up of waste products in the blood. Rejection of a kidney transplant may present with fever, pain at the transplant site, and changes in urine output. Renal colic usually presents with intense pain in the lower back or side, related to kidney stones.

2. A nurse is providing anticipatory guidance to a client who has Phenylketonuria (PKU) and is planning a pregnancy. Which of the following information should the nurse include in the discussion?

• A. Diet sodas should not be consumed more than two or three times a week.
• B. Serum bilirubin should be monitored once or twice a month during pregnancy.
• C. Breastfeeding will not prevent your baby from developing PKU.
• D. A low-protein diet should be followed for three months before conception.

Correct answer: D

Rationale: A low-protein diet should be followed for three months before conception in individuals with PKU who are planning a pregnancy. This diet helps manage PKU by reducing phenylalanine levels, which is crucial for maternal and fetal health. Choices A, B, and C are incorrect. Choice A is not directly related to managing PKU, choice B focuses on a different aspect of care during pregnancy, and choice C is inaccurate as breastfeeding will not prevent a baby from developing PKU.

3. A client who is breastfeeding is being taught diet modification by a nurse. Which of the following statements by the client indicates an understanding of the teaching?

• A. I should drink an 8-ounce glass of water each time my baby nurses.
• B. I should take a 1500-milligram iron supplement daily.
• C. I can eat a 2500-calorie daily diet to lose 1 lb per week.
• D. I can eat ounces of swordfish daily.

Correct answer: A

Rationale: The correct answer is A because drinking an 8-ounce glass of water each time the baby nurses helps maintain hydration and support milk production. Choice B is incorrect as the need for iron supplementation should be discussed with a healthcare provider. Choice C is incorrect as a 2500-calorie diet is not typically recommended for weight loss during breastfeeding. Choice D is incorrect as consuming high levels of swordfish is not advisable due to its mercury content, which can be harmful to the baby.

4. A nurse is providing teaching about food allergies to the parents of a toddler. Which of the following foods should the nurse identify as highest risk for allergies in toddlers?

• A. Eggs
• B. Milk
• C. Bananas
• D. Citrus fruits

Correct answer: A

Rationale: The correct answer is A: Eggs. Eggs are one of the most common food allergens in toddlers and should be introduced carefully. Milk (choice B) is also a common allergen but is typically introduced earlier in a child's diet. Bananas (choice C) and citrus fruits (choice D) are less likely to cause allergic reactions compared to eggs.

5. Which type of immunity is demonstrated by the transfer of a mother's immunoglobulin across the placenta to protect the child?

• A. Natural active immunity
• B. Natural passive immunity
• C. Artificial active immunity
• D. Artificial passive immunity

Correct answer: B

Rationale: The immunoglobulin passed from the mother to the child through the placenta is an example of natural passive immunity, making choice B the correct answer. This transfer gives the child temporary immunity to various diseases without their immune system having to work. On the other hand, natural active immunity (Choice A) occurs when the body produces its own antibodies in response to an antigen. Artificial active immunity (Choice C) is achieved through vaccinations, where the immune system is stimulated to produce antibodies against a specific disease. Artificial passive immunity (Choice D) is a temporary immunity that involves the transfer of pre-formed antibodies from another source.

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